Rebranding of the Medicare and Medicaid EHR Incentives Program

On May 7, 2018, the Centers for Medicare and Medicaid Services (“CMS”) released a proposed rule that would rebrand the current Medicare and Medicaid Electronic Health Records (“EHR”) Incentives program into the Promoting Interoperability program (“PI”).

The EHR incentives program, created in 2011, encouraged eligible providers to adopt, implement, upgrade and demonstrate meaningful use of certified electronic health record technology (“CEHRT”). This program awarded over 544,000 health care providers with payment by February 2018.

With the great success of the incentives program, CMS is proposing changes that would create more transparency between patients and providers through greater access to health care information. To relieve burden to patients, and increase the ability to exchange health information among providers and patients, sharing and extracting files across systems is a new CEHRT requirement. Moreover, it will support increased patient access to their personal health information through secure email transmissions. The proposed PI program would also provide patients access to hospital price information via the internet.

In addition to increasing patient support, the PI program reevaluated cost efficiency of the current EHR incentive program. The current program uses Clinical Quality Measures (“CQM”), which extract data from EHR systems to measure the quality of health care services and then assess the outcome of treatment provided to patients. CQMs are costly, and upon reevaluation of the current incentives program, CMS determined that the costs of several of the current CQMs outweigh the intended benefits.  Therefore, the PI proposes to remove seven of the 16 current CQMs.

In sum, the proposed changes would benefit both patients and providers by promoting interoperability, greater flexibility for providers, and reducing burdens on patients and providers by increasing the ability to obtain and exchange health information.

For over 30 years, Wachler & Associates has represented healthcare providers and suppliers nationwide in a variety of health law matters, including the defense of Medicare overpayments. If you or your healthcare entity have any questions about the EHR incentive program, or any other health care regulatory compliance questions, please contact an experienced healthcare attorney at (248) 544-0888, or via email at wapc@wachler.com. You may also subscribe to our health law blog by adding your email at the top right of this page.